Individual provider Active NPI

Sabrina Tyer-Mbaye, RN

  • General Practice Registered Nurse
  • Atlanta, GA
National Provider Identifier
1659041267
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
RN241800 Issued in GA
Practice address
3909 Campbellton Rd SW Apt G4
Atlanta, GA 30331-5021
Phone
(470) 430-0076
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN241800 GA Primary

Addresses

Primary practice location

3909 Campbellton Rd SW Apt G4
Atlanta, GA 30331-5021

Mailing address

1821 Anderson Ave NW
Atlanta, GA 30314-1835
Phone (470) 794-2477

Other identifiers 4

IdentifierTypeStateIssuer
0000000000MedicaidGA
0000000000OtherGANON MEDICAID
049233169OtherGADEPT OF DRIVER SERVICES
0000000000MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL Atlanta
CONNECT URL Atlanta Health Information Exchange (HIE)
CONNECT URL Atlanta Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN241800GAMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1659041267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 ANDERSON AVE NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303141835",
            "telephone_number": "470-794-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 CAMPBELLTON RD SW APT G4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315021",
            "telephone_number": "470-430-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYER-MBAYE",
        "first_name": "SABRINA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "RN241800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000000",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON MEDICAID",
            "identifier": "0000000000",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF DRIVER SERVICES",
            "identifier": "049233169",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000000",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Atlanta",
            "affiliation": "N",
            "address_1": "3909 Campbellton Rd SW Apt G4",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303315021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Atlanta",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3909 Campbellton Rd SW Apt G4",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303315021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Atlanta",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3909 Campbellton Rd SW Apt G4",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303315021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.